门控心肌断层显像定量分析心肌灌注和心室功能  

Gated SPECT with 99m Tc- MIBI for Quantitative Assessment of Myocardial Perfusion and Wall Function

作　　者：刘建中[1] 胡光[1] 张承刚[1] 韩树杰[1] 李思进[1] 王进[1] 

机构地区：[1]山西医科大学第一临床学院核医学科

出　　处：《临床医学影像杂志》1998年第2期101-103,共3页

摘　　要：目的：评价一次显像同时获得心肌灌注和心肌壁收缩功能、室腔射血功能的改变在冠心病中的临床意义。方法：①用自动门控定量分析软件，获得舒张末期容积（ＥＤＶ）、收缩末期容积（ＥＳＶ）和ＬＶＥＦ对正常、心梗、心肌缺血三组做了统计和分析。②将舒张末期（ＥＤ）灌注、局部ＥＦ、局部壁运动、和壁增厚度４个靶心图各划分为９个区段计算心梗组各项异常节段并作分析。结果：①心梗组和正常组心室功能参数差别有显著性，心肌缺血组与正常组差别无显著性。②心梗组灌注异常节段大多伴有心肌壁功能受损（６７／８３），但存在更多心肌壁功能受损节段在灌注正常区（１８个）；灌注异常阶段中尚有１０个节段壁功能正常。结论：门控心肌断层显像整体心室功能参数在心梗的评价中有优越性对心肌缺血的诊断价值不大；心梗中存在有不少的局部灌注与心肌壁功能异常节段的不匹配。PURPOSE:To evaluate the clinical value of myocardial perfusion and wall contraction function simultaneously with 99m Tc-MIBI gated SPECT.METHODS:41 subjects, 14 normals and 27 patients(17 patients with myocardial infarction MI, 10 patients with ischemic heart disease)were statistical analyzed (1)from global EDV(end-diastole volume)、 ESV(end-systole volume)and LVEF(left ventricular ejection fraction)obtained with auto-quantitation program and (2) from regional perfution、EF、motion and thickening by 4 polar maps in MI group. RESULTS:There was statistically significant difference for global LV function parameters(EDV、ESV、LVEF)between normal group and MI group(p<0 01)and there were not statistically significant difference between normal group and ischemic group. Regional perfusion abnormal combine most regional wall contractive function lessens(67/83),however there were not matching between perfusion and wall function. There were 18 perfusion segments in regional the wall function lessens segments and 10 wall function normal segments in the perfusion abnormal segments. CONCLUSIONS: Global LV function parameters have higher values in assessment of MI and not have advantage in diagnose of CAD. In the patients with myocardial infarction,not matching between the regional perfusion and wall contraction function is useful to assessment of myocardial viability.

关 键 词：心肌灌注 心室功能 门控断层 心肌存活 心肌梗塞 

分 类 号：R542.2[医药卫生—心血管疾病]